NURS 120/NURS120 Final Exam Review | Questions and Answers | Latest Update | 100% Correct | Verified Elaborations | GRADED A- WCU

NURS 120/NURS120 Final Exam Review | Questions and Answers | Latest Update | 100% Correct | Verified Elaborations | GRADED A- WCU Question: The nurse is caring for a patient of another culture. Which step should the nurse initiate first in the cultural assessment to provide culturally competent care to this patient? Perform a self-assessment. Identify the patient's beliefs and values. Identify the patient's health practices. Ask the patient about their family structure. Perform a self-assessment. Question: The nurse is planning short term goals for a patient. Which goal should be included? A. Quit smoking. B. Lose 50 pounds. C. Lower cholesterol by 30 points. D. Sleep 8 hours per night. D. Sleep 8 hours per night. Question: The nurse plans to obtain subjective data from the patient. Which action should the nurse take to obtain this information? A. Take the patient's blood pressure. B. Order a lab draw to check blood glucose. C. Ask the patient to stand and walk. D. Ask the patient to rate pain. D. Ask the patient to rate pain. Question: Which statement by the nursing student indicates that further teaching is needed on the nursing process? A. "The nursing process is a method of addressing clinical problems." B. "The nursing process is one area of nursing that has been without criticism." C. "The nursing process is a creative approach to thinking and decision making." D. "The nursing process is the cornerstone of nursing standards." B. "The nursing process is one area of nursing that has been without criticism." Question: The nurse professor is giving a lecture on Dorothy Orem. Which statement by one of the nursing students indicates that teaching has been effective? A. "An underlying assumption of Orem's model is that patients want to be in control of their lives." B. "Orem's work focuses on goal attainment, for and by the patient." C. "Orem focused on the patient as a biopsychosocial adaptive system." D. "Orem believed that unless attention was paid to the patient's concerns, mutual goal setting was unlikely." A. "An underlying assumption of Orem's model is that patients want to be in control of their lives." Question: The RN is working on a busy surgical floor, with a team including an LPN and an UAP. Which duty can the RN delegate to the UAP? A. Assessment of the post-operative patient B. Wound care for a patient with a left above knee amputation C. Administration of oral pain medications D. Vital signs every hour D. Vital signs every hour Question: Which formal socialization activities can the student nurse take part in to build skills? (Select all that apply.) A. Attending lectures B.Nursing clinicals C. Starting an IV D. Overhearing nurses discuss patient care E. Observing an unplanned intervention for a patient A. Attending lectures B.Nursing clinicals Question: A group of nursing students is listening to a lecture on nursing history and the many definitions of nursing. Which statements by one of the students indicates that the teaching has been effective? (Select all that apply.) A. "Giving nursing a clear definition encourages higher wages." B. "A definition establishes boundaries." C. "A definition clarifies the purpose of nursing." D. "Having a definition clarifies the functions of nursing." E. "A definition guides educational preparation of nurses." A. "Giving nursing a clear definition encourages higher wages." B. "A definition establishes boundaries." C. "A definition clarifies the purpose of nursing." D. "Having a definition clarifies the functions of nursing." Question: The nurse is listening to a lecture on the pioneers of early nursing, including the works of Hildegard Peplau. Which statement by the nurse indicates that teaching has been effective? A. "Peplau developed the self-care theory of nursing." B. "Peplau believed that the patient should be an active collaborator in care." C. "Peplau included the concept of the nursing process in her definition of nursing." D. "Peplau wrote the popular book, Notes on Nursing: What it is and What it is Not." B. "Peplau believed that the patient should be an active collaborator in care." Question: The nurse professor is giving a lecture on The Future of Nursing report (2011), published by the Institute of Medicine. Which statement(s) by one of the students indicates that the teaching has been effective? (Select all that apply.) A. "Nurses must practice to the full extent of their education and training." B. "Nurses should strive to obtain associate degrees, so that they may begin practicing immediately." C. "Nurses should be full partners in health care transformation." D. "Improved data collection can result in more effective workforce planning." E. "Improved data collection can result in more effective policy development." B. "Nurses should strive to obtain associate degrees, so that they may begin practicing immediately." C. "Nurses should be full partners in health care transformation." D. "Improved data collection can result in more effective workforce planning." Question: A prospective student in interested in becoming a nurse, and has is meeting with an academic advisor. The student is looking for a program that is low cost, with evening study opportunities and shorter duration programs. Which nursing entry program should the advisor suggest? A. The diploma program B. The baccalaureate degree program C. The associate degree program D. RN to BSN program C. The associate degree program Question: The nurse professor is giving a lecture on autonomy. Which statement indicates that the teaching has been effective? A. "Autonomy guides nurses in ethical decision making." B. "Autonomy means that the nurse has control over his/her own practice." C. "Autonomy means that nurses are motivated by service." D. "Autonomy means that nurses consider their work an important component of their lives." B. "Autonomy means that the nurse has control over his/her own practice." Question: The nurse case manager is discussing the difference between a profession and an occupation with a nursing student. Which statement should the nurse case manager make, to accurately define a profession? A. "Professionals will often change career paths." B. "Professionals are often motivated by reward." C. "Professionals often feel that they are called to their profession." D. "Professionals do not consider their profession as an integral part of their lives." C. "Professionals often feel that they are called to their profession." Question: The nurse is presenting a lecture on nursing image, and how to keep this image positive. Which statement by the students indicates that further education is needed? A. "Ignore negative images in nursing." B. "Contact those responsible for negative nursing images." C. "Boycott programs or films that promote negative images of nurses." D. "Contact those who share positive images of nursing." A. "Ignore negative images in nursing." Question: The nurse is listening to a lecture regarding the nursing education of African Americans during the early 1900s. Which statement indicates that the teaching has been effective? A. "African-Americans were strictly prohibited from entering a nursing school." B. "Mary Eliza Mahoney was the first professionally trained African-American nurse in the United States." C. "Atlanta Baptist Female Seminary did not allow African-American students to apply." D. "African-American nurses often served as nursing professors." B. "Mary Eliza Mahoney was the first professionally trained African-American nurse in the United States." Question: The nurse is presenting a lecture on the first nursing schools in the United States. Which statement by one of the attendees indicates that the teaching has been effective? A. The first nursing school open in the United States in 1902." B. "Linda Richards was the first trained nurse in the United States." C. "The first three nursing schools were opened in Maine, Florida and Michigan." D. "Clara Barton was the first nurse graduate after the civil war." B. "Linda Richards was the first trained nurse in the United States." Question: The nurse educator is presenting a lecture on the contributions of Dorothy L. Dix. Which statement by one of the students indicates that the teaching has been effective? A. "Dix was a Jamaican and a business woman." B. "Dix founded the first school of nursing in London." C. "Dix sold food and drinks to officers and spectators during the Crimean war." D. "Dix was a long-time advocate for the mentally ill in the prewar years." D. "Dix was a long-time advocate for the mentally ill in the prewar years." Question: The nurse educator is presenting a lecture on the contributions of Florence Nightingale. Which statement from one of the students indicates that the teaching has been effective? A. "Nightingale established a hotel for sick and injured soldiers." B. "Nightingale was often referred to as a physician or doctress." C. "Nightingale founded the first school of nursing." D. "Nightingale was a Jamaican nurse and business woman." C. "Nightingale founded the first school of nursing." Question: The nurse is attending a lecture on the advancements in telehealth. Which statement from a colleague indicates that the teaching has been effective? A. "Telehealth expands healthcare access to underserved populations." B. "Patient data cannot be remotely monitored." C. "Telehealth is a separate nursing specialty." D. "The fastest growing applications of these technologies are inpatient hospitals." A. "Telehealth expands healthcare access to underserved populations." Question: The nurse manager wants to encourage staff nurses to enroll in an RN-BSN program. Which patient centered outcomes are likely to encourage the staff nurses to obtain a higher degree level? A. Nurses with advanced degrees are given more vacation days. B. Patients cared for by BSN (or higher) prepared nurses have more positive outcomes. C. Patient satisfaction scores are higher with BSN (or higher) prepared nurses. D. Patients won't use their call lights as much. B. Patients cared for by BSN (or higher) prepared nurses have more positive outcomes. Question: The nurse educator is providing a lecture on practice settings for nurses. Which statement from a new nurse indicates that the teaching has been effective? A. "The most common practice setting for new nurses is home care." B. "Hospitals remain the primary worksite for RNs." C. "Nursing homes employ 10% of the nursing workforce." D. "Many new nurses gain experience in medical offices." B. "Hospitals remain the primary worksite for RNs." Question: Which decisions and actions to achieve Transcultural Nursing Care did Madeleine Leininger include in her theory? Select all that apply. a. Cultural preservation b. Cultural care accommodation c. Cultural patient-based care d. Cultural care restructuring a. Cultural preservation b. Cultural care accommodation d. Cultural care restructuring Question: Which aspects are included in the The Adaptation model of Nursing developed by Sister Callista Roy? Select all that apply. a. The human being b. Adaptation c. Administration d. Nursing a. The human being b. Adaptation d. Nursing Question: Match the nursing roles as identified by Peplau in her "Seven Nursing Roles" with the most appropriate description/behavior of this role. a. Stranger role → b. Counseling role → c. Surrogate role → d. Technical expert role → - provides physical care for the patient and operates equipment. - provides an atmosphere to build trust -as an advocate on behalf of the patient - helping the patient understand the meaning of current circumstances a. Stranger role → provides an atmosphere to build trust b. Counseling role → helping the patient understand the meaning of current circumstances c. Surrogate role → as an advocate on behalf of the patient d. Technical expert role → provides physical care for the patient and operates equipment. Question: When a nurse is answering his/her patient's questions on the dangers of skin cancer, the nurse is serving in what role, as identified in Hildeguard Peplau's Seven Nursing Roles Theory? a. Surrogate b. Stranger c. Resource d. Leader c. Resource Question: Which theory is associated with Dorothy Orem? a. Adaptation model b. Self-care model c. Theory of need d. Theory of goal attainment b. Self-care model Question: Due to her nightly rounds during the Crimean war, which theorist became known as "Lady with the Lamp"? a. mary seacole b. Margaret sanger c. Florence nightingale d. Dorothy dix c. Florence nightingale Question: King's theory of goal attainment discusses the three interacting systems: personal. Interpersonal and social. Which concept below align with the social system? a. Perception and self growth b. Communication and role c. Stress and boy image d. Authority and decision making d. Authority and decision making Question: Which theorist would respond in the manner: How can I create an environment of trust, understanding, and openness so that the patient and I can work together in meeting his or her needs? a. Florence nightingale b. Virginia Henderson c. Jean Watson d. Madeline leininger c. Jean Watson Question: Match the role of the nurse in the theory by Virginia Henderson that best aligns with that role. a. Collaboratively → b. Substitutive → c. Supplementary → d. Complimentary → - helping the patient do something - working with the patient to do something - doing something for the patient b. Substitutive → doing something for the patient c. Supplementary → helping the patient do something d. Complimentary → working with the patient to do something Question: Which statement reflects a defining feature of Jean Watson's theory? a. Caring consists of caring for oneself as well as others b. Caring consists of caring for oneself only c. Individuals should keep all emotions to oneself d. It is not necessary to connect with another human being a. Caring consists of caring for oneself as well as others Question: What are the four major concepts of Watson's nursing process? (select all that apply) a. Human being b. Health c. Environment d. Technology e. Nursing f. Family a. Human being b. Health c. Environment e. Nursing Question: 12. Which factors contribute to the empowerment of nurses? Select all that apply. a. Workplace that encourages collaboration b. A belief in one's ability c. Workplace that maintains traditional hierarchy d. Recognition of the importance of caring e. Media portrayal of nurses as assistants to doctors a. Workplace that encourages collaboration b. A belief in one's ability d. Recognition of the importance of caring Question: 13. Which domains are essential in empowering nurses? Select all that apply. a. Autonomy b. Educational preparation c. Engagement in patient affairs d. Involvement in hospital policy a. Autonomy b. Educational preparation d. Involvement in hospital policy Question: 14. The nurse enters a patient's room and finds the patient has fallen and lying on the ground. Which actions should the nurse take next? a. Assess the patient and provide needed care b. Take vital signs and notify the doctor c. Check for injuries and fill out an incident report d. Call the fall team and document the incident in patient's chart a. Assess the patient and provide needed care Question: 15. What actions can a nurse take to improve the nursing image? Select all that apply. a. Be confident in the nurse's actions and knowledge b. Wear a care or scrubs with cartoons to make patients feel at ease c. Returning to the patient's room when promised d. Maintain eye contact with all patients e. Engage in positive conversation about the role of nursing a. Be confident in the nurse's actions and knowledge c. Returning to the patient's room when promised e. Engage in positive conversation about the role of nursing Question: 16. Which action can then nurse take to improve the nursing image? a. Wear white uniforms b. Make a first good impression with patients c. Volunteer for the extra shifts d. Friending patients on Facebook following discharge b. Make a first good impression with patients Question: 17. A nurse walks into a patient's room and finds the patient on the floor. The states that he hit his head and is in a lot of pain. What should the nurse document in the chart about the incident. Select all that apply. a. Patient state "I hit my head". b. An incident report was filed c. Patient was found on the floor responsive and alert d. Patient's vital signs and pain level. a. Patient state "I hit my head". c. Patient was found on the floor responsive and alert d. Patient's vital signs and pain level. 18. The registered nurse (RN) is working with an unlicensed assistive personal (UAP). Which task should the RN complete? a. Take vital signs b. Chart intake and output c. Administer intravenous medication d. Collect routine urine sample c. Administer intravenous medication 19. The nurse is inquiring about a newly admitted patient's pain level by asking "What is your pain level on a scale of 1-10"? which level of the nursing process is reflected in this action? a. Assessment b. Implementation c. Intervention d. Evaluation a. Assessment 20. the nurse is working with a patient and setting patient-centered goals. Which patient characteristics are essential for this process to occur? The patient is... a. alert and oriented b. ambulatory and un-medicated c. able to speak and write d. able to read and write a. alert and oriented 21. a patient presents to the emergency room with shortness of breath (SOB), cough with productive thick green sputum, and a history of smoking a pack a day. Vital signs are as follows: Temp: 100.8 F, P: 110, RR: 22, BP: 134/86, Pulse ox 93%. Which nursing diagnosis is priority? a. Risk for infection r/t green sputum as evidenced by SOB and elevated temperature b. Impaired gas exchange r/t thick secretion as evidenced by 93% pulse ox and RR 22. c. Deficient knowledge r/t smoking history as evidence by productive cough d. Anxiety r/t pneumonia as evidenced by abnormal vital signs b. Impaired gas exchange r/t thick secretion as evidenced by 93% pulse ox and RR 22. 22. A nurse is completing a stressful 12 hour shift in the ICU and is now asked by the nurse manager to stay 4 more hours due to another nurse "calling out". By agreeing to stay, the nurse is most at risk for which condition? a. Post-traumatic stress b. Chronic fatigue c. Burnout d. Reality shock c. Burnout 23. What actions can a nurse take to avoid burnout? Select all that apply. a. Accept extra overtime b. Set boundaries c. Join a yoga class d. Participate in a graduate nurse support group. b. Set boundaries c. Join a yoga class d. Participate in a graduate nurse support group. 24. The nurse is interested in creating a local health promotion and maintenance services. Which actions should the nurse take? a. Speak to a city council representative about local rehabilitation programs b. Organize a support group for people with congestive heart failure c. Rally to increase awareness of child restraint laws d. Teach prenatal classes at a community center d. Teach prenatal classes at a community center 25. The nurse is listening to a presentation on shared governance. Which statement indicated a need for further education? a. "shared governance promotes decentralization." b. "shared governance encourages nursing participation at BSN level and above" c. "self-scheduling is an example of shared governance" d. "shared governance improves patient outcomes" d. "shared governance improves patient outcomes" 26. The nurse has just listened to a lecture on the roles of the nurse. Which action should the nurse take to fulfill the educator role? a. Provide health screenings to the public b. Teach new mothers the benefits of breastfeeding c. Coordinate patient care during a 12 hour shift. d. Create patient assignments for the night shift. b. Teach new mothers the benefits of breastfeeding 27. The nurse is educating the patient on Medicaid. Which statement by the patient indicates a need for further education? a. "Eligibility requirements are determined by the federal government" b. "participants are not required to pay fees" c. "Medicaid is funded by state and federal governments" d. "the level of benefits varies from state to state" a. "Eligibility requirements are determined by the federal government" 28. The nurse is listening to a lecture on levels of health care. Which statement indicates that further teaching is necessary? a. Primary care is provided in emergency departments b. Primary care is the point at which the patient enters the health care system c. Primary care if provided by a cardiologist d. A major goal of the primary health care system is to provide health maintenance c. Primary care if provided by a cardiologist define occupation "a person's regular work, profession, job or principal activity" define profession "occupational group with a set of attributes and/or behaviors" Attributes of a profession - College or university - Mental creativity - Decisions based on science or theoretical constructs - Values, beliefs, & ethics - Commitment - Autonomous - Unlikely to change - Commitment $ reward - Individual accountability Attributes of an occupation - On the job training - Manual work - Guided decision making - Absence of values, beliefs & ethics - Commitment varies - Supervised - Motivated by $ reward - Employer is accountable Barriers to professionalism - Varying levels of preparatory - education - Gender Issues - Historical Influences - External Conflicts - Internal Conflicts examples of a nurse demonstrating professionalism - Clinical judgment - Communication - Professional identity - Leadership - Ethics Florence Nightingale - founder of modern nursing - Provided nursing care during the Crimean War - Founder of Nursing Profession - Aseptic Techniques/infection control - Nursing Research - Political activism - Established first nursing school in London - Introduced system of transcribing orders and maintaining patient records - Published "Notes on Nursing: What It is and What It Is Not" Mary Seacole - Funded herself to serve soldiers in the Crimean War - Woman of mixed race - Set up a hospital near the war front and visited soldiers on the battlefield Dorothy Dix - Advocate for the work of female nurses - Administration of military hospitals during civil war - long-time advocate for the mentally ill in the prewar years Mary Ann Bickerdyke - Nursing of soldiers during the civil war Clara Barton - Founded the American Red Cross - Hospital nurse during the civil war Linda Richards - 1st grad of Boston Training School Mary Mahoney - 1st African American - grad from New England Training School for Women and Children Isabel Hampton Robb started ANA Lillian Wald - Henry St. Settlement - Nursing addressed the serious health conditions related to the influx of immigrants Crimean war and the development of nursing as a profession - Nightingale focused on improvements in sanitation, nutrition and activity for the patients in the hospital, since more soldiers were dying from diseases such as typhus, typhoid, cholera and dysentery than from wounds - On her return to Great Britain, Nightingale advocated for improving conditions in hospitals, using statistics from the Crimean war American civil war and the development of nursing as a profession - Prompted the beginning of formal education for nurses despite a lack of formal training "nurses" - Dorothy Dix, Mary Ann Bickerdyke, and Clara Barton Henry Street Settlement (1893) and the development of nursing as a profession - Founded by Lillian Wald - Nursing related to the influx of immigrants - Funding from private sources - first formalized Public Health Nursing practice Spanish American War (1898) and the development of nursing as a profession - epidemic of typhoid fever - Not enough staff or supplies - development of the Army Nurse Corps (1901) and Navy Nurse Corps (1908) Instituting Nursing Licensure and the development of nursing as a profession - title protection - examinations - nation-wide state board test pool exam WWI and the development of nursing as a profession - Army School of Nursing - Government formed the National Committee on Nursing - nursing in military given ranks - Increase use of hospitals Great Depression and the development of nursing as a profession - Increase in nurse unemployment - Civil Works Administration (CWA) - Hospital forced to close schools of nursing - hospitals no longer had students to staff hospitals - Social Security Act WW2 and the development of nursing as a profession - Nurse cadet corps - In association with colleges Hill-Burton Act (1946) and the development of nursing as a profession - Provided funds to construct hospitals - rapid expansion lead to acute nursing shortage - team nursing - AD programs created Medicare and Medicaid (1965) and the development of nursing as a profession - Ensured access to health care for elderly, poor, disabled - Increased employment of nurses in hospitals - Reform led to first NP define clinical judgement an interpretation or conclusion about a patient's needs, concerns, or health problems, and/or the decision to take action (or not), use or modify standard approaches, or improvise new ones as deemed appropriate by the patient's response 4 examples of a nurse using clinical judgement 1) noticing 2) interpreting 3) responding 4) reflecting Reflection-in-action happens in real time while care is occurring Reflection-on-action happens after the patient care occurs steps of the nursing process 1) assess 2) diagnose 3) plan 4) implement 5) evaluate 3 types of diagnoses 1) problem focus 2) risk 3) health promotion SMART goals Specific: patient centered Measurable Attainable Realistic Timely 3 types of nursing interventions 1) Independent: nurse initiated 2) Dependent: physician initiated 3) Interdependent: collaborative (protocols) all 3 levels of nursing education 1) diploma programs 2) associate degree programs 3) baccalaureate programs associate degree programs - program focuses more on technical skills than theory, and for 30 percent of ASN graduates it is their stepping stone to a BSN. - An ADN takes about two years and is usually offered at a community college or vocational school diploma programs - run by hospitals - you are a student but also staff the hospital bsn programs - A BSN degree is preferred by most nursing leaders and provides the best opportunities in today's job market. - recommended standards regarding education of nursing - establish a clear system of nursing inducing pathways for educational mobility and development of educational programs - nurses should be highly educated - student should not be used to staff hospitals - standards should be established for nursing practice Licensure - state regulation of the nursing practice - Required of individuals at the entry point to practice and must be renewed periodically - assessing basic and continuing competence. - Compact vs. non-compact State licensure Certification - validates knowledge and competency beyond licensure - Professional organizations will certify you [ANA] - Requirements for certification determined by the certifying body Accreditation - regulated by ACEN and CCNE - accreditation was established to demonstrate that a college has met certain standards - Accreditation is meant to help people identify schools that will provide and uphold a certain quality of education NCLEX-RN - candidate specific - computer based - variations in length - tests competency - 75 Q min, 265 Q max roles of UAP/CNA - Provide Basic care/ADL - Routine clinical tasks - Vital signs; collecting urine/stool samples; I&O - Room preparation - Patient ambulation & transport - Must be stable situations with - predictable outcomes roles of LPN - Perform routine assessments and skills - cannot do initial assessments - cannot do complicated assessments - Deliver basic care - Perform routine tasks with predictable outcomes - Perform routine wound care/dressing changes - Perform uncomplicated sterile procedures (wound dressing, foleys, etc.) - Perform specialized "skills" with proper training in stable situations - Meds - Observe & report - Reinforce teaching Cannot Administer ... Antineoplastic agents IV Blood products Chemo drugs Total parenteral nutrition (TPN) Titrate medications roles of RN - Perform physical exams and health histories - Provide health promotion, counseling and education - Administer medications, wound care, and numerous other personalized interventions - Interpret patient information and make critical decisions about needed actions - Coordinate care, in collaboration with a wide array of healthcare professionals - Direct and supervise care delivered by other healthcare personnel like LPNs and nurse aides - Conduct research in support of improved practice and patient outcomes PIE Problem, intervention, evaluation APIE Assessment, problem, intervention, evaluation SOAP Subjective, objective, assessment, plan SOAPIE, SOAPIER Subjective, objective, assessment, plan, intervention, evaluation, (revision) Focus charting (DAR) Data, action, response Reality Shock - "Powerlessness and ineffectiveness experiences by new grads" - Nursing shortage - Absence of positive reinforcement - Lack of support - Lack of ability due to heavy case load - Gap between what is taught in school and actual working setting strategies to lessen reality shock - Recognize school cannot provide all learning experiences - If possible gain some outside health care experience - Care for self - Preceptor/mentor programs - Gain support from peers - Need balance between work and personal lives Burnout - Physical, mental and emotional exhaustion - Disengagement - Leads to detachment and dulled emotions - Impacts nurses and nursing care - Linked to increased infections in patients and poor health in nurse - lower patient satisfaction rates decrease or to avoid burnout - Set boundaries - Process your emotions - Manage your stress - Find an outlet in creativity Novice Students enrolled in school & depend on rules and expectation Advanced beginner marginally competent, still struggling with prioritization Competent practitioner (2-3 yrs.) organized efficient most of time, multi-task, critical thinking Proficient practitioner (3-5 yrs.) patient holistically, prioritize needs, concern with patient outcomes not just rules Expert practitioner extensive clinical practice, intuitive, may find it difficult at times to verbally explain their actions - care comes to them naturally actions a nurse can take to enhance empowerment 4 cognitions of empowerment: - Meaning - Competence - Self determination - Impact Nursing to be empowered must have: - Workplace that promotes empowerment - A belief in one's ability to be empowered - Recognizing that power is in relationships and caring that nurses provide continuum of cultural competency 1) cultural destructiveness 2) cultural incapacity 3) cultural blindness 4) cultural pre-competence 5) cultural competence 6) cultural proficiency Process of cultural competence 1) awareness 2) knowlede 3) skills 4) encounters 5) desire components/steps of cultural assessment 1) self assessment 2) open ended, focused and contrasted questions 3) data collection - origins, family, communication, personal beliefs, daily routine 4) considerations - space and distance, eye contact, time, touch, communication, holidays, diet, biological/environmental variations 5) mnemonics LEARN Listen, Explain, Acknowledge, Recommend, Negotiate RESPECT Rapport, Empathy, Support, Partnership, Explanations, Cultural Competence, Trust ETHNIC Explanation, Treatment, Healers, Negotiate, Intervention, Collaboration C-LARA Calm, Listen, Affirm, Respond, Add explain the role for nurse informaticist - Help manage, interpret and communicate vital medical data - Work with information systems to help patients manage their own health - Develop storage and analytic technology to optimize data for research - Work to develop medical technology the "good" of the EHR - Improved data accessibility - Computerized physician order entry - Improve medical billing - Preventive Health - E-messaging between providers the "bad" of the EHR - Lack of interoperability between IT and HER - Cost of set-up and maintenance - Delays in documentation - Need for updates and accountability the "ugly" of the EHR - Human error in entering data. Empty data fields - Maintaining security of data - HIPAA violations 4 categories of tele-health 1) mHealth, (mobile health) 2) remote patient monitoring 3) store-and-forward care (asynchronous) 4) live video (synchronous) legal and ethical concerns of technology use - Protecting private information - Patient safety - unauthorized access to patient information - Sign off computers when leaving - Any printouts from the system be shredded immediately when no longer needed - Reducing potential medical and nursing errors QSEN (Quality & Safety Education for Nurses) Competencies created in response to challenges of preparing future nurses 1) patient centered care 2) teamwork and collaboration 3) evidence based practice 4) quality improvement 5) informatics 6) safety IOM (Institute of Medicine) goal: help those in government and the private sector make informed health decisions by providing evidence upon which they can rely 6 aims for improvement of the IOM - Safety - Patient-centeredness - Efficiency - Effectiveness - Timeliness - Equity 5 core competencies of the IOM - Utilize informatics - Provide patient centered care - Apply quality improvement - Employ evidence based practice - Work in interdisciplinary teams QA: quality assurance - Methods & tools help agencies conform to standards required by external accrediting agencies - REACTIVE APPROACH - Ensure the delivery of quality client care - Takes action for change when care does not meet standards CQI: continuous quality improvement - Proactive approach - Builds on QA - Uses scientific process - Focuses on internal and external "clients" categories of healthcare 1) Health promotion and maintenance, including early detection 2) Illness prevention: prevention, intervention, education 3) Diagnosis and treatment 4) Rehabilitation and long-term care organizational structure of hospitals/health care institutions 1) board of directors 2) ceo 3) coo 4) medical staff - doctors - interns, residents, fellows - chief of staff 5) nursing staff - CNE - CNO - VP - director of nursing - RN, LPN, UAP/CNA - nurse administrators subjective data refers to information from a patient's point of view, such as pain levels, feelings and perceptions objective data refers to measurable aspects of a patient's condition found through diagnostics, tests and examination what must a Problem focused diagnosis contain? - Problem (NANDA - label and definition) - Etiology (related factors) - Symptom (defining characteristics) ^MUST contain all 3 what are the two most important things that the NCLEX tests? safe care & competency what company enacted a campaign to enhance the image of nursing? Johnson & Johnson computer science implementation and application of computer systems, (programming, computer elements hardware, software, networks etc.) information science mathematical theories based upon statistics concerned with coding, transmitting, storing, retrieving and decoding information nursing science evidence based practice, research, & theory based practice clinical application of technology telemedicine In what year did nursing licensure become mandatory? 1903 sentinel event unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof and they signal the need for immediate investigation and response failure to rescue The term refers to cases where caregivers fail to notice or respond when a patient is dying of preventable complications in a hospital. near-miss to detect system weaknesses before the occurrence of serious harm rapid response team Purpose is to identify and treat patients before the patients' condition deteriorates to the point that CPR is needed Failure Mode Effect Analysis (FEMA) Is a systematic method for evaluating a process to identify where and how it fail, and to assess the relative impact of different failures in order to identify the parts of the process that are most in need of change. cultural awareness examine one's own cultural & professional background, including biases; recognize the risk of imposing your beliefs on others cultural knowledge seeking info about different cultures/ethnic groups; focus on integration of health related beliefs & values cultural skill collect relevant data & perform a culturally based physical assessment, taking into account how the variations may affect the accuracy of the assessment cultural encounters interactions with clients from diverse backgrounds will prevent stereotyping, but still won't make you an expert cultural desire Foundation is caring Want to engage in process rather than have to Passion to be open, flexible, & willing to learn from others ethnocentrism inclination to view one's own cultural group as the standard by which to judge the value of other cultural groups social security act est during great depression to enhance public health services with nurses becoming the major avenue for providing care Person, environment, health, nursing: 4 concepts included in the nursing ________________ metaparadigm Models that provide an organized structure that makes clearer connects between concepts conceptual model Visual representation of patient problems that show relationships to one another concept maps correct method of payment for US healthcare 1) medicare (a - hospital, b-medical, d-pharmacy) -- state 2) medicaid (elderly, disabled, poor) -- state and federal 3) private 4) workers comp 5) out of pocket